Background of the invention
Field of the invention
[0001] The present invention relates to the determination of the presence of leukocytes,
or other esterase activity, in a test sample. Moreover, the invention relates to a
semi-quantitative test which is rapid and which dispenses with the need for microscopic
examination or wet chemistry laboratory procedures.
[0002] The presence of an abnormal level of leukocytes in a patient's urine is possibly
indicative of such pathological conditions as kidney or urogenital tract infection
or other dysfunction. Accordingly, accurate urinary leukocyte information can be an
invaluable tool to the physician in diagnosis and treatment of such pathologies. Traditionally,
the medical profession has relied on visual determination techniques to count leukocyte
population in urine sediment or uncentrifuged urine, a process requiring expensive
equipment such as a centrifuge and microscope, as well as a great deal of time on
the part of the clinician. Moreover, the traditional techniques suffer from the inadequacy
that only intact cells are determined. Leukocytes occurring in the urinary system
are subject to conditions which can favor extensive cell lysis. For example, it is
known that in urines of abnormally high pH, leukocyte half life can be as low as 60
minutes. Since lysed cells escape detection in visual examination techniques, erroneously
low determinations and false negatives can result.
[0003] Of the two techniques of microscopic leukocyte analysis-urine sediment and non-centrifuged,
homogenized urine-the former is clearly the most desirable. Although dependable results
can inure to the latter, urine sediment observation is used in an overwhelming majority
of instances. It requires that the urine sample be centrifuged and the sediment isolated
and subjected to microscopic inspection. The analyst then counts the number of leukocytes
appearing in the viewing field. However, this task is further complicated by the presence
of other urinary components in the sediment such as epithelial cells and salt particles.
The varying content of sediment constituents, coupled with other complicating factors
including non-homogeneity of the sample and varying optical powers of microscope equipment,
can lead to enormous errors in the ultimate determination.
[0004] It is thus apparent that a quick, facile method of leukocyte determination, one which
would eliminate the need for time-consuming techniques, as well as cost-consuming
equipment, and which would provide accurate results whether the cells were intact
or had been lysed, would indeed advance the state of the art by a quantum jump. The
present invention provides such an advance. It is based, not on the ability to see
leukocytes, but on the enzymatic activity they exhibit, and therefore is not subject
to the inaccuracies described above.
Description of the prior art
[0005] There exists in the prior art a body of references which disclose the use of certain
esters which, when cleaved by enzymatic activity, result in the formation of color
or other detectable species. Thus, British Patent No. 1,128,371 discloses the use
of indoxyl and thioindoxyl esters as useful chromogens in detecting hydrolytic enzymes
in body fluids. The enzymes cleave the ester to generate free indoxyl, which subsequently
oxidizes to form the dimeric product indigo, a readily observable blue dye. Such activity
is said to be due to, among other enzymes, cholin- esterase. This patent also teaches
that, in addition to the indoxyl portion of the ester substrate, the acid radical
is chosen with particular reference to the enzyme to be detected. For example, it
is stated that the acid radical can be acetate, laurate or stearate for detection
of esterase or lipase. For detecting enzymes such as phosphatase or sulfatase the
acyl radical can be inorganic. Thus, the British Patent can be held to teach the use
of chromogenic esters as substrates for determining esterolytic enzymes, such esters
comprising indoxyl or thioindoxyl as the alcoholic moiety of the ester, the acyl moiety
being tailored to be conductive to the particular enzyme to be determined.
[0006] The effect of careful acyl radical selection is nowhere more clearly exemplified
than in two references which demonstrate esterase specificity for esters in which
the acyl radical comprises an N-protected amino acid or peptide. Thus Janoff, et al,
Proc. Soc. Exper. Biol. Med. 136.1045-1049 (1971) teaches the alanine esters are specific
substrates for esterase obtained from human leukocytes. Specifically this reference
teaches that an extract of human leukocyte granules hydrolyzed n-acetyl-/-alanyl-/-alanyl-/-alanine
methyl ester. Moreover, I-alanine-p-nitrophenol ester was similarly hydrolyzed to
yield the yellow p-nitrophenol colorform.
[0007] Similarly, Sweetman et al., Jour. Hist. Soc., 22:327-339 teaches the use of 1-naphyl
N-acetyl-DL- alanine and 1-naphthyl butyrate to demonstrate the- presence of esterase,
as well as 1-naphthyl N-acetyl-l-alanyl-l-analyl-1-alanine.
[0008] United States Patent No. 4,278,763, assigned to Boehringer Mannheim GmbH combines
these teachings in arriving at the indoxyl or thioindoxyl esters of amino acids or
peptides as still another example of a traditional colorogenic substrate for leukocytic
esterase activity. Like the Janoff and Sweetman references, the Boehringer patent
teaches the equivalence of proteases and esterase in their esterolytic penchants.
[0009] Other prior art teachings with respect to leukocyte determination include the peroxidative
activity of granular leukocytes (U.S. Patent No. 3,087,794). Such an approach, however
cannot distinguish between leukocytes and hemoglobin, and one cannot tell whether
a positive test is indicative of white or red blood cells.
[0010] Finally, there is available commercially a product known as "Cyturtest" which utilizes
N-tosylalanine indoxyl ester referred to, supra. This product comprises a filter paper
pad impregnated with the amino acid indoxyl ester. The pad is mounted on a plastic
strip. When immersed in a leukocyte-containing urine sample, a colour appears on the
filter paper pad due to the formation of indigo. However, this test suffers from the
drawback of having a considerably lengthy waiting period (about 15 minutes) before
the test results can be assessed.
[0011] Thus, although the use of chromogenic esterase substraces is well-entrenched in the
prior art, and despite the existance of esterase affinity towards indoxyl alaninate
and peptidate, there exists no truly rapid test for leukocytes in urine. It is towards
solving this problem that the present invention is directed.
[0012] Based on a concerted effort of research and development, it was discovered that a
particularly facile test for the presence of leukocytes in urine could be had in a
test time of only 3-4 minutes and less, thus overcoming a serious drawback of the
prior art.
Brief summary of the invention
[0013] Briefly stated, the present invention comprises a composition, test device and method
for determining esterase activity in a test sample. The composition comprises (a)
a chromogenic ester having the formula

in which R is a moiety which produces a detectable response when the ester is cleaved
through an esterase or esterase-like esterolytic reaction, and in which R' is an amino
acid or peptide moiety having a nitrogen protective group, and (b) 3-quinuclidinol.
The device comprises a carrier matrix incorporated with the composition. The method
comprises contacting the device with a liquid test sample and observing any detectable
response in the carrier matrix.
Detailed description of the invention
[0014] As used herein, the terms "esterase activity", "chromogenic ester", "detectable response",
and "esterase or esterase-like reaction" and "esterolytic reaction" shall have the
meaning defined as follows. "Esterase activity" shall mean that quality of a test
sample whereby the sample behaves like the enzyme esterase. Accordingly, the presence
of esterase activity in a test sample exhibits itself by being capable of cleaving
a chromogenic ester substrate, defined below, and in such a manner as defined below.
[0015] "Chromogenic ester" shall mean an ester having the structure defined herein, in which
one of the products of esterolytic cleavage, namely the alcoholic residue of such
cleavage, is capable of producing a detectable response, either by itself or through
further reaction.
[0016] By the term "detectable response" is meant a change in, or appearance of, a physical
parameter which can be sensed by human or instrumental observation. Thus the detectable
response can be the appearance of, or change in, visible color in the carrier matrix
of the presently disclosed test device, or in a solution in which the composition
is dissolved or suspended. The response can also be a change in the amount of light
absorbed or reflected by the carrier matrix. For example the carrier matrix can be
analyzed by use of a reflectometer or spectrophotometer. The reflected or absorbed
light which is measured can be within a wide range of wavelengths, from infrared to
ultraviolet. Alternatively, the detectable response can be in the form of the appearance
of chemiluminescence. Depending on the selection of R in the chromogenic ester, i.e.,
the alcoholic moiety, it can be seen that a wide variety of detectable response is
possible with the present invention, and the kind and degree of response is indeed
broad in scope.
[0017] As used herein, the terms "esterase reaction", "easterase-like reaction" and "esterolytic
reaction" shall apply to any reaction whereby the cleavage of a chromogenic ester
into its alcoholic and acyl components is catalyzed, whether such catalysis is due
to the presence of an esterase or whether it is attributable to some other sample
component which exhibits esterase activity.
[0018] The chromogenic ester of the composition is characterized by two general criteria:
an alcoholic moiety R which produces a detectable response when the ester is saponified
or esterolytically cleaved, and an acyl moiety R which comprises an amino acid or
peptide residue, wherein the amino group is substituted with a nitrogen protective
group. Typical of R are such chromogens as indoxyl (3-hydroxy-indole) and thioindoxyl
and their derivatives, as well as p-nitrophenol, and p(a-nitrovinyl) phenol. Substituted
and unsubstituted indoxyl and thioindoxyl moieties are described in British Patent
No. 1,128,371 and U.S. Patent No. 4,278,763, both of which patents are incorporated
herein by reference.
[0019] The acyl portion of the ester, i.e., the amino acid or peptide residue, is also intended
as being broadly defined. Accordingly, the amino acid residue includes one of the
a-amino acids in the L-or D-form. Especially preferred is L-alanine, but preferred
embodiments also include glycine, valine, leucine, isoleucine, phenylalanine and tyrosine.
Any free hydroxyl groups are preferably acylated.
[0020] If R' is to be a peptide, the present invention envisions those having about 1-5
amino acid constituents. Preferred are di- and tripeptides of the above-mentioned
amino acids.
[0021] The N-protective groups which are conventionally employed in peptide chemistry, as
well as others, are included herein by the term "nitrogen protective group". Included
are such groups as acyl, oxycarbonyl, thiocarbonyl, sulphonyl, sulphenyl, vinyl, cyclohexenyl,
phosphoryl or carbonyl.
[0022] Accordingly, the composition of the present invention comprises a chromogenic ester
and 3-quinuclidinol. It has been found that inclusion of the latter compound dramatically
decreases the reaction time of cleavage of a chromogenic ester by a sample having
esterase activity. By inclusion of 3-quinuclidinol in the composition, read times
are decreased several fold; from 15 minutes without the compound, to 2-3 minutes and
less when it is present together with the chromogenic ester.
[0023] In view of General and Pharmaceutical Sciences 1983, Vol. 62, No. 4, pages 684 and
685 this effect is very unexpected. This reference teaches that 3-quinuclidinol-hydrochlorid
is a competitive inhibitor of acetylcholinesterase. It-can therefore, be regarded
as a surprising result that the addition of 3-quinuclidinol to a composition for the
determination of esterase activity in a test solution would lead to dramatically increased
reaction rates.
[0024] 3-Quinuclidinol has the formal name of I-aza- bicyclo [2.2.2] octan-3-ol, and has
the structure

It exists in optically active isomeric forms, each of which has distinct physical
properties. The dl- form can be crystallized from acetone or benzene to yield crystals
melting at 225-227°C, and which sublime at 120°C and 20 mm Hg. The /-isomer forms
prisms melting at 220-222°C. The compound has been used by itself or as one of its
derivatives as a hyptoensive drug. See "Merck Index", Ninth Edition, page 1052, Entry
No. 7905, Merck & Co., Inc., Rahway, N. J. (1976). It has also been reported as useful
for cleaving (3-keto esters. See "Aldrich Catalog Handbook", page 826, Aldrich Chemical
Co., Milwaukee, WI (1981-1982).
[0025] Although the respective amounts of chromogenic ester and 3-quinuclidinol present
in the composition is not deemed critical, it has been found desirable-to that they
be present at a molar ratio of ester to 3-quinuclidinol in the range of 1:5 to 100.
It has been found especially useful to use a composition in which the molar ratio
is 1:30 to 75.
[0026] In addition to the above ingredients, the composition may also contain an alcohol
having 1-20 carbon atoms. Preferred is an alcohol having 8-12 carbon atoms. Illustrative
of such alcohols which may be included in the composition, and which have been found
especially preferred, are any of the isomers of decanol, especially n-decanol.
[0027] The test device of the present invention comprises a carrier matrix incorporated
with the composition, thereby providing a tool for rapid, reliable estimations of
the presence of leukocytes or other source of esterase activity in a test sample.
The carrier matrix is usually, but not necessarily, a porous substance such as filter
paper. Other art-recognized forms of carrier matrix materials are felt, porous ceramic
strips, and woven or matted glass fibers (U.S. Pat. No. 3,846,247). Also suggested
are the use of wood, cloth, sponge material and argillaceous substances (U.S. Pat.
No. 3,552,928). All such carrier matrix materials are feasible for use in the present
invention, as are others. It has been found that filter paper is especially suitable.
[0028] In a preferred embodiment, filter paper is wetted with a solution or suspension of
solution of 3-quinuclidinol in aqueous buffer (pH about 8.5), or other suitable vehicle
easily determinable by routine laboratory experiments, and then dried. The dried filter
paper is subsequently incorporated with a solution of the chromogenic ester. Generally
the ester solution is in an organic solvent, such as acetone. Other solvents which
can be convenient to use include methanol, ethanol, N,N-dimethylformamide and dimethylsulfoxide.
Following impregnation with the ester solution, the filter paper is dried to yield
a test device sensitive to the presence of leukocytes or other source of esterase
activity.
[0029] The dried, reagent-bearing carrier matrix can be mounted on a backing material if
desired. Thus, a preferred embodiment of the test device, comprises a filter paper
carrier matrix, incorporated with the composition as described supra, the matrix being
affixed to one side to an elongated piece of transparent polystyrene film. The matrix
is secured to one end of the film by any suitable means, such as double faced adhesive
tape (Double Stick@ available from 3M Company), the other end of the polystyrene film
serving as a handle. In use, such a device is held by the free end of the polystyrene
film backing material and the matrix end is immersed into the test sample (e.g., urine)
and quickly removed. Any color formation or other detectable response is observed
after a predetermined time and compared with a reference standard corresponding to
responses to known concentrations of leukocytes or other analyte having esterase activity.
It has been found that an incubation time of about 1-3 minutes is sufficient to enable
color development to occur in the reagent-containing filter paper.
Examples
[0030] The above-mentioned and other embodiments of the present invention can more easily
be illustrated by reference to the following Examples. However, apart from their illustrative
function, they are not intended, nor are they to be interpreted, as limiting in any
way the scope of the invention.
Example I-Control test device
[0031] An experiment was conducted to prepare a test device useful in determining the presence
of leukocytes in a liquid test sample. Broadly, the device comprises a filter paper
square (about 0.2 centimeters on a side) which had been impregnated with a chromogenic
ester, indoxyl-N-tosylalaninate and n-decanol. A piece of filter paper was immersed
successively in each of two dip solutions with drying following each immersion. The
resulting dried reagent-containing paper was cut into 0.5 cm squares, one of which
was attached to the end of an oblong polystyrene strip measuring about 10 cm by 0.5
cm. Adhesion between the paper and the plastic was achieved through the use of double-faced
adhesive tape known as Double Stick, available from the 3M Company.
[0032] The first dip solution comprised a borate buffer solution to which was added an anionic
detergent (Bio Terge AS-40) and potassium bromate. The borate buffer (pH=8.6) was
prepared by adding 4.5 milliliters (ml) of a 0.2 M boric acid solution to 5.5 ml of
a 0.05 M borax solution, all in distilled water. To this solution was added a sufficient
volume of Bio-Terge AS-40 (an anionic detergent available from Stepan Chemical Co.)
to effect a 0.2 ml/deciliter (dl) solution. The resultant solution was made 10 mM
(millimolar) in potassium bromate.
[0033] A piece of Eaton and Dikeman 205 filter paper was briefly immersed in the first dip
solution and dried in an air oven at 100°C for 20 minutes. A second dip solution comprised
an acetone solution of polyvinylpyrrolidone, n-decanol, quinine . HCI, and 3-(N-tosyl-L-alanyl-oxy)
indole. The resultant concentrations of solutes were as follows:
1 mlldl Polyvinylpyrrolidone in methanol (Luviskol available from GAF Corp.)
2 mlldl n-Decanol
10 mM quinine hydrochloride
2 mM 3-(N-tosyl-L-alanyl-oxy)indole The dried filter paper from the first dip was
immersed in the second dip and dried in an air oven at 60°C for 5 minutes. A 0.5 cm
square of dried paper was mounted on a polystyrene strip, as described, supra.
[0034] In order to test the efficacy of the test device in measuring the presence of leukocytes,
a solution of contrived urine containing a known concentration of leukocytes was prepared
and frozen subsequent to its use to assess the test strip. A portion of this contrived
urine was defrosted and contained a leukocyte concentration of 3.3 leukocytes per
microliter (pl). One of the devices was dipped into this test sample momentarily,
removed, and allowed to incubate. After 14 minutes sufficient color had developed
in the strip to enable a determination of a positive test.
Example II-Effect of 3-Quinuclidinol
[0035] An experiment was conducted to test the effects of the compound 3-quinuclidinol on
the performance of a strip similar to that prepared in Example I. Accordingly, the
procedure of Example I was followed except that the first dip solution was made 50
mM in 3-quinuclidinol and 10 mM in potassium ferrocyanide (instead of bromate). Drying
of the filter paper after the first immersion was at 80°C for 25 minutes. Also, the
second dip solution contained 0.2 ml/dl n-decanol, 1.5 mlldl polyvinylpyrrolidone
and 1.5 mM 3-(N-tosyl-L-alanyloxy)indole.
[0036] In order to assess the performance of the quinuclidinol-containing test device, the
solution of contrived urine utilized in Example I was employed. Accordingly, the test
device was dipped into the urine solution and allowed to incubate. After 4 minutes,
sufficient color had developed in the reagent strip to indicate a positive for the
presence of leukocytes in the contrived urine samples.
Example III-A preferred embodiment
[0037] An experiment was conducted to further improve the results of Example II. Accordingly
the procedure of Example I was followed, except as noted below, in preparing a test
device.
[0038] The first dip solution comprised a pyrophosphate buffer at pH=
8.
6. This was prepared by making up a solution of 0.2 M sodium pyrophosphate (Na
4P
20
7) in distilled water, and adding slowly sufficient crystals of metaphosphoric acid
[(HP0
3),,] until the resultant solution was at pH=8.6. To this solution was added a sufficient
volume of Bio Terge AS-40 to effect a 0.2 ml/dl solution. Next, the solution was made
10 mM in potassium ferrocyanide, and 50 mM in 3-quinuclidinol.
[0039] A piece of Eaton and Dikeman filter paper was immersed in the first dip, removed
and dried at 80°C for 35 minutes.
[0040] A second dip solution was prepared in acetone. It contained 0.2 ml/dl n-decanol,
2.0 ml/dl polyvinylpyrrolidone in methanol (Luviskol), and 1 mM 3(M-tosyl-L-alanyloxy)
indole.
[0041] The dried filter paper from the first dip was immersed in the second dip, removed,
and dried at 60°C for 7 minutes. A 0.5 cm square of the resultant carrier matrix was
mounted on a polystyrene strip as in Example I to form a test device.
[0042] The device was tested using three contrived urine samples, each having a specific
gravity of 1.010 and being contrived to 0, 8.3 and 25 polymorphonuclear leukocytes
per microliter (PMN/pl), respectively. These solutions were designated "negative",
"trace" and "positive", respectively. The test devices were observed by six persons
experienced in interpreting dip-and- read test devices. In order to assure objectivity
in the observer, the contrived urine samples were not labeled. Each observer momentarily
dipped a test device in a urine sample, removed it, and observed it after incubation
periods of 1, 2 and 3 minutes.
[0043] A colour chart was prepared for use in the study, i.e., for comparison with color
developed in the test device, which had been prepared beforehand, corresponding to
negative, trace (8.3 PMN/ pl) and positive (25 PMN/pl), respectively. Thus, three
devices prepared herein were dipped, one in each of three urine samples which were
negative, trace and positive in leukocytes, allowed to incubate for 2 minutes, and
the colors noted. Color blocks were then prepared corresponding to the color developed
after 2 minutes in the test devices.
[0044] Each color block was assigned an arbitrary number: 10=negative, 20=trace and 30=positive.
The six persons participating in the blind study were asked to read each strip at
1, 2 and 3 minute intervals following dipping and removing from a particular contrived
urine sample. Each person then assigned a numerical value to color development for
each time interval and for each urine sample. The results are as follows:

[0045] The data shows color differentiation between various leukocyte concentrations at
1 minute, with excellent differentiation at 2 minutes.
1. Mittel zur Bestimmung der Anwesenheit von Esteraseaktivität in einer flüssigen
Testprobe, wobei das Mittel umfasst
einen chromogenen Ester der Formel

worin R eine Kompenente darstellt, die ein nachweisbares Signal liefert, wenn der
Ester durch eine Esterase- oder Esterase-ähnliche esterolytische Reaktion gespalten
wird, und worin R' eine Aminosäure oder Peptidkomponente mit einer Stickstoff-Schutzgruppe
darstellt, dadurch gekennzeichnet, dass das Mittel in weiteren 3-Chinuclidinol umfasst.
2. Mittel nach Anspruch 1, dadurch gekennzeichnet, dass R Indoxyl oder Thioindoxyl,
vorzugsweise Indoxyl, darstellt.
3. Mittel nach Anspruch 1, dadurch gekennzeichnet, dass R' einen Aminosäurerest darstellt.
4. Mittel nach Anspruch 1, dadurch gekennzeichnet, dass R' einen Peptidrest darstellt.
5. Mittel nach Anspruch 1, dadurch gekennzeichnet, dass R' N-Tosyl-alaninat darstellt.
6. Mittel nach Anspruch 1, dadurch gekennzeichnet, dass der chromogene Ester Indoxyl-N-tosylalaninat
darstellt.
7. Mittel nach einem oder mehreren der Ansprüche 1 bis 6, dadurch gekennzeichnet,
dass das Mittel in weiteren einen Alkohol mit 1 bis 20 Kohlenstoffatomen umfasst.
8. Testvorrichtung zur Bestimmung. der Anwesenheit von Esteraseaktivität in einer
flüssigen Testprobe, dadurch gekennzeichnet, dass die genannte Vorrichtung eine Trägermatrix
umfasst, in welcher das Mittel nach einem oder mehreren der Ansprüche 1 bis 7 inkorporiert
ist.
9. Verfharen zur Bestimmung der Anwesenheit von Esteraseaktivität in einer flüssigen
Testprobe, dadurch gekennzeichnet, dass man die Testprobe mit der Testvorrichtung
nach Anspruch 8 in Kontakt bringt und die Trägermatrix in Hinblick auf ein nachweisbares
Signal beobachtet.